While most of us are tentatively inspecting our roofs and gardens for damage after a storm has passed, some people must get straight on with the task of helping those in need.
The aftermath of a hurricane, in fact, is one of the most hectic times of the year for nurses in King Edward VII Memorial Hospital’s Dr Beresford Swan Dialysis Unit.
Nearly 100 patients undergo regular dialysis at KEMH to remove excess fluid and waste products from their blood. It’s life-saving treatment, so pushing back an appointment a couple of days to wait for the roads to be cleared and the buses to start running isn’t an option.
Fortunately, the Dialysis Unit has a well-oiled system to ensure all patients get the treatment they need, whether that means nurses driving around carnage to reach patients at their homes or enlisting police to track down seniors who have lost their phone connection.
Vernahl Darrell, clinical manager of dialysis, insisted this is all done with a smile on the face.
“It’s fun, because we know our patients,” she said.
“We see them three times a week and have known many of them for years. They know us very well and we have a different kind of relationship with them. We’ll laugh at the things that happen.”
One example involved a dialysis patient who needed to be collected from her home in Warwick immediately after a storm.
“We couldn’t get hold of her,” Ms Darrell said. “I said OK, I live nearby, let me just nip round. When I got there, she saw me first and disappeared. We went looking for her, and eventually found her crouching behind her house. She was hiding because she didn’t want to come to dialysis!”
The patient ended up getting her treatment and the team now laugh with her about it, but dialysis is a serious business.
Loumeeka Orgill-Bell, clinical resource nurse in the Dialysis Unit, explained: “These patients cannot go to the bathroom to clear the poisons that are in their system. If those poisons remain in the system, they are going to cause problems, sometimes death.
“They could also wind up with fluid overload, where they can’t breathe, and it becomes an emergency. Or they can also have levels of potassium that can affect their heart. If it gets to significant levels, it will put them in a crisis.
“Dialysis allows them to be maintained at a normal therapeutic level so that they are able to continue with life. It’s a life-saving procedure.”
Emergency preparations on the unit begin as soon as it becomes clear a hurricane is heading for Bermuda.
All patients are contacted and, where necessary, urged to head in for their appointments before the storm. They’re given a list of foods to keep their potassium levels and fluid intake at the appropriate levels and advised to keep their contact information close at hand.
“We need them to keep out of harm’s way as they hunker down,” Ms Orgill-Bell said. “We don’t know how long we’re going to be in that state where we’re not able to access things as we normally could.”
Ms Darrell added: “We encourage them to keep abreast of updates from the emergency broadcast station and make sure they have a working transistor radio and batteries. We also tell patients to expect a phone call about when dialysis will reopen and of course to stay safe.”
Dialysis patients who live in St George’s or St David’s – currently numbering 14 – are encouraged to stay with friends or relatives the other side of the Causeway, so that they don’t end up stranded if it gets damaged.
Ms Darrell said this was a harsh lesson learnt when the Causeway closed after one storm and East End dialysis patients had to be carried to Blue Hole Hill via a police boat in order to attend the hospital for their treatments.
The dialysis department shuts during the storm, apart from an on-call nurse. As soon as it’s safe to go outside, the tricky task of rounding up patients begins.
“We listen to the emergency channel to find out which roads are impassable,” Ms Darrell said.
“The police come into play because sometimes there are massive areas that don’t have electricity so we can’t contact them. We call the police and we give them the patients’ addresses and they pick them up or find and notify them.”
Ms Orgill-Bell said: “We’re blessed in Bermuda because our small proximity makes it easier for accessibility. Also, because we have experienced so many hurricanes, we have gotten the structure where everyone knows their part and they play it well. Sometimes we take that for granted.”
BHB currently has six patients on peritoneal dialysis, where they dialyse themselves with a small portable unit. While they don’t need to visit the hospital, they might have to switch their methods if they lose electricity.
“They come in and do refresher training,” Ms Orgill-Bell said. “If electricity is lost, they have to be able to perform a manual therapy which would require solution bags. Because they haven’t been doing it for a while, remembering exactly what they need to do can be a little fuzzy.
“We have lucked out very well in terms of storms, where we haven’t had any major incidents with the peritoneal dialysis patients. They do a great job.”
That’s not to say storms always pass without any hiccups.
“You can guarantee, at some point during the hurricane, some of the early 4 o’clock patients are going to arrive at the hospital right in the middle of the hurricane,” Ms Darrell laughed.
“I will get either a call or WhatsApp message to say, ‘So and so is here.’ I think they just decide they’re going to drive through the storm! They stay in the lobby until we reopen.”
